Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Patient-Oriented Research to Improve Internet-delivered Cognitive Behavioural Therapy for People of Diverse Ethnocultural Groups in Routine Practice

Ram P. Sapkota
ORCID logo ,
Emma Valli
,
Andrew Wilhelms
,
Kelly Adlam
,
Lee Bourgeault
,
Vanessa Heron
,
Kathryn Dickerson
,
Marcie Nugent
ORCID logo ,
Heather D. Hadjistavropoulos
* ORCID logo
Version 1 : Received: 25 May 2023 / Approved: 26 May 2023 / Online: 26 May 2023 (09:46:55 CEST)

A peer-reviewed article of this Preprint also exists.

Sapkota, R.P.; Valli, E.; Wilhelms, A.; Adlam, K.; Bourgeault, L.; Heron, V.; Dickerson, K.; Nugent, M.; Hadjistavropoulos, H.D. Patient-Oriented Research to Improve Internet-Delivered Cognitive Behavioural Therapy for People of Diverse Ethnocultural Groups in Routine Practice. Healthcare 2023, 11, 2135. Sapkota, R.P.; Valli, E.; Wilhelms, A.; Adlam, K.; Bourgeault, L.; Heron, V.; Dickerson, K.; Nugent, M.; Hadjistavropoulos, H.D. Patient-Oriented Research to Improve Internet-Delivered Cognitive Behavioural Therapy for People of Diverse Ethnocultural Groups in Routine Practice. Healthcare 2023, 11, 2135.

Abstract

There has been limited research on improving Internet-delivered Cognitive Behavioural Therapy (ICBT) in routine online therapy clinics that serve people from diverse ethnocultural groups (PDEGs). This article describes a patient-oriented adaptation approach used to address this gap in research. A working group consisting of people with lived experience, community stakeholders, ICBT clinicians, managers, and researchers, was formed. The working group examined archival feedback on ICBT from past clients who self-identified as being from diverse ethnocultural back-grounds (N=278) and results of interviews with current patients (N=16), community stakeholders (N=6), and clinicians (N=3). The archival data and interviews revealed the majority of the pa-tients reported being satisfied with and benefitting from ICBT. Suggestions for improvement were not related to the cognitive-behavioural model and techniques, but rather to making treatment materials more inclusive. Consequently, the ICBT adaptation focused on adding content related to cultural influences on mental health, addressing stigma, diversifying case stories, examples and imagery, adding audiovisual introductions, and replacing English idioms with more descriptive language. Moreover, further training was offered to clinicians and efforts were made to improve community outreach. This study demonstrates a process for using patient-oriented research to improve ICBT within routine care serving patients of diverse backgrounds.

Keywords

internet-delivered therapy; depression; anxiety; cultural adaptation; patient-oriented research; digital health

Subject

Public Health and Healthcare, Public Health and Health Services

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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